Urology Coding Alert

Question: My urologist performed a ureteroscopy with laser ablation of ureteral tumor. This isn't for a stricture but a low-grade transitional cell carcinoma of the lower ureter. Therefore, I don't think 52344 is appropriate. How should I code this procedure?

Indiana Subscriber

Answer: You should report 52354 (Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with biopsy and/or fulguration of ureteral or renal pelvic lesion) for the laser fulguration/vaporization of the ureteral tumor. Use diagnosis 189.2 (Malignant neoplasm of kidney and other and unspecified urinary organs; ureter).

You are correct that you should not use 52344 (Cystourethroscopy with ureteroscopy; with treatment of ureteral stricture [e.g., balloon dilation, laser, electrocautery, and incision]) since the urologist was not treating a stricture.

Answers to Reader Questions and You Be the Coder contributed by Michael A. Ferragamo, MD, FACS, clinical assistant professor of urology, University Hospital, State University of New York, Stony Brook.